Blue cross nc provider portal

Blue cross nc provider portal. Effective November 1, 2021, EnrollSafe replaces CAQH Enrollhub as the electronic funds transfer (EFT) enrollment portal for providers. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provides free aids to service people with disabilities as well as free language services for people whose primary language is not English. BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Feb 27, 2024 · On February 21, 2024, Blue Cross and Blue Shield of North Carolina’s (Blue Cross NC) pharmacy benefit manager, Prime Therapeutics, alerted us of a nationwide system outage affecting the company, Change Healthcare (CHC). To obtain prior review, always enter the Carelon Provider Portal in Blue e, regardless of Blue Cross NC COB carrier status (primary, secondary or tertiary). If you get health coverage through an employer: Contact your group administrator or HR department to make changes to your account. About Blue e Provider Portal Blue Cross and Blue Shield of North Carolina is an Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers several decision-support tools to aid you in making decisions around your health care experience. Try our Find Care search tool to find them. The Blue Book is an online reference manual for products, value-added programs and services for providers participating in the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) network. These tools are offered for your convenience and should be used only as reference tools. The Blue Connect℠ personalized member services portal keeps everything you need in one place. Nov 1, 2021 · Please note, this communication applies to Healthy Blue + MedicareSM (HMO D-SNP) offered by Blue Cross and Blue Shield of North Carolina. Updated Description, Policy Guidelines, and References sections. Blue Cross NC makes health insurance easy. All NC Providers must provide their 5-digit Blue Cross Blue Shield of North Carolina (Blue Cross NC) provider ID# below. Blue Cross NC may contract with independent third-party vendors for the provision of certain aspects of our wellness programs and is not liable in any way for goods or services received from them. Developers can register for access here and find the resources they need to build an application programming interface ( API ) to a member’s Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is working with providers to improve how and when behavioral health concerns are identified and treated. Unlock more great benefits with MyBlue. Members are still expected to select a primary care physician (PCP). Blue Distinction is a designation awarded by Blue Cross NC and other Blue Cross and Blue Shield companies to medical facilities that have demonstrated expertise in delivering quality health care. Aug 29, 2024 · Effective November 1, 2024, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will transition medical necessity review of outpatient therapy services for Commercial Fully Insured members (including professional and home) to Carelon Medical Benefits Management (Carelon). Ready to become a provider in the Anthem network? We look forward to working with you to provide quality service for our members. You can also access Blue e, the secure online portal that lets you check eligibility, claims status, and more. Sep 13, 2021 · In October 2021, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will launch upgrades to our Care Affiliate portal to create a modern and streamlined design meant to enhance navigation and information display. Learn how to join, recredential, or register for payment with Blue Cross NC network. For health plans, providers and health care clearinghouses, the critical portions of the act are the Administrative Simplification provisions, which include new standards for electronic transactions that took effect Oct. com (Accessed July 2022). Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers several decision-support tools to aid you in making decisions around your health care experience. You can also call us to learn more about purchasing a plan. BCBS FEP Dental members can utilize the GRID+ network as an in-network provider source. Blue Cross NC offers wellness programs as a convenience to aid members in improving their health; results are not guaranteed. That’s why Blue Cross and Blue Shield of North Carolina uses Availity, a secure and full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to Healthy Blue contracted providers. Easily find the right in-network providers and care options. Manage Your Plan; Prescription Drugs; Find Care; See Plan Perks; Live Official Site of Anthem Blue Cross Blue Shield, a trusted health insurance plan provider. Individual and family plans (under age 65) About Blue e Provider Portal Medical Record Submission call 800-214-4844 for the Blue Cross NC Provider Blue Line. ©2024 Blue Cross and Blue Shield of North Carolina. Get the Blue Cross NC forms and documents for providers that you need all in one place. May 10, 2024 · Blue Cross and Blue Shield of North Carolina (“Blue Cross NC,” "Company," "We," “Our” or “Us”) respects your privacy and is committed to protecting it. Oct 11, 2021 · As a reminder, beginning October 15th, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will launch upgrades to our Care Affiliate portal to create a modern and streamlined design meant to enhance navigation and information display. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. This results in faster payment than paper checks. With MyBlue, you get 24/7 access to smart, simple tools and resources. HQIP is Blue Cross NC's Pay-for-Performance program for acute care hospitals. If a member-specific, dose-specific injectable drug is ordered from a network vendor - do not file a claim with Blue Cross NC for the drug. Blue Cross NC helps you find a formulary, search for meds, and get prior approvals. ® Marks of the Blue Cross and Blue Shield Association. Effective 1/1/2008, Blue Medicare HMO and Blue Medicare PPO members have the freedom to choose in-network providers and specialists without a referral. MHK Provider Portal (accessed via Blue e), SureScripts, or fax. . The Blue Book is designed to assist you in understanding and administering Blue Cross NC health insurance products, health coaching and intervention Medicaid Expansion Tools and Resources. Blue Cross NC Provider Appeal Department PO Box 2291 Durham, NC 27702 Independent licensees of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. ACS is an independent company Inquiries about our medical policies can be made by mail to the addresses listed below or you can call our Customer Service Department at 877-258-3334. Hospitals can earn a reimbursement increase if they meet quality and performance targets. Communications issued by Capital Blue Cross in its capacity as administrator of programs and provider relations for all companies. If medical records are needed to support a medical necessity review and are not received by Blue Cross NC before the claim adjudicates, the member will receive an Explanation of Benefits (EOB), the provider will receive an Explanation of Payment (EOP), and both will receive a claim denial letter addressing the specific reason(s) for the denial. All other marks are the property of their respective owners. Navigation. Jul 3, 2024 · Last updated July 3, 2024. Learn about Experience Health, a new and innovative insurance company owned by Blue Cross NC. Enrollment in Blue Cross and Blue Shield of North Carolina Senior Health depends upon contract renewal. Be advised that certain self-administered drugs have been excluded from Blue Cross NC's medical benefits but are covered under the prescription drug benefit. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. For questions regarding your contract, please call Blue Cross NC Network Management line at 800-214-4844, (Blue Cross NC) BlueCross NC Provider Portal; Mar 12, 2024 · Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Proof of prior dental coverage with less than 63 days lapse in coverage is required. It also means not having to worry if a check is lost, stolen or damaged. As a reminder, Care Affiliate is the provider portal for managing authorizations that is accessed via Blue e. To help North Carolinians know who is eligible and how to apply, the North Carolina Department of Health and Human Services (NCDHHS) has a website that contains a bilingual toolkit and a sign-up form to stay updated on the most current information about how Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers several decision-support tools to aid you in making decisions around your health care experience. + ICD-10 - Get resources and tools to help you prepare for ICD-10 implementation. Get an Enrollment and Change Application from Customer Service (call the number on the back of your member ID card) or through your employer. Sep 27, 2021 · Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has launched a value-based care program to ensure Blue Cross NC members with kidney disease have access to better, more affordable health care. This policy describes the types of information we may collect from you or that you may provide when you visit or use our Website, including any subdomains (“Website”), our Blue Connect ℠ Member Portal (“Member Portal Blue Cross Blue Shield Association internal data; February 2023. Together, we can help the whole person thrive by bringing physical and behavioral health together. The vendor will bill Blue Cross NC directly. Participating physicians already using Blue e can view their current fee schedule in the portal. Dec 10, 2012 · + Blue Medicare - See information specifically for Blue Medicare HMO SM and Blue Medicare PPOSM providers. Welcome to the Blue Connect and Blue Cross of North Carolina Member Self-Service Portal. Continuity of Care Form (PDF) Mail: Blue Cross and Blue Shield of North Carolina Care Management PO Box 2291 Durham, NC 27702-2291; Fax: 800-228-0838 I'm registered but need portal access. Welcome to BCBSNC, the official website for Blue Cross and Blue Shield of North Carolina providers. Claims, appeals, and inquiries. Allows members and their dependents to continue receiving care from a provider who is no longer in the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) network. The survey is online with only a few questions that will take less than 4 minutes of your time. Blue Cross NC provides fee schedule information electronically to participating physicians. By participating in the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plan, you now have access to BCBS FEP Dental members. Providers. Beginning July 1, Carelon will retire the “Check Order Status” on the portal, and providers should instead use “Order Search” going forward. Provider portal Get answers to questions, access real-time patient information, check claims status, enter and view authorizations, and more. Yes, Blue Cross NC may waive or reduce any applicable dental waiting period by the number of months of prior dental coverage. Blue e is a free online tool for providers to check patient eligibility, submit claims, and more. Aug 20, 2024 · Every year, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) invites providers to complete the National Committee for Quality Assurance (NCQA) Access to Care Accreditation survey. Submission of this form is only a request for services and does not guarantee approval; not all Blue Cross NC plans provide benefit coverage for PHP. Blue Cross NC has a free app that allows members to securely connect to their health plan from a mobile device. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Designed to be simple and convenient, Blue Connect Mobile helps customers get up-to-the-minute information about their health plan and helping them manage costs. The designation is based on rigorous, evidence-based selection criteria established in collaboration with expert physicians and medical organizations. North Carolina’s Health Information Exchange Network, NC HealthConnex, is a secure, computer-based electronic network for doctors, hospitals and other health care providers to share information that can improve your care – so that no matter where you are providers can access your information. Blue Cross and Blue Shield of North Carolina Senior Health DBA Blue Cross and Blue Shield of North Carolina is an HMO-POS D-SNP plan with a Medicare contract and a NC State Medicaid Agency Contract (SMAC). If you have any problems logging in to the Blue e network or Blue Premier, please call the eSolutions HelpDesk at 1-888-333-8594 Option 1 or your system administrator. + IPP BlueCard® - Get resources for providers who service out-of-state Blue Cross/Blue Shield members. Changes will be posted to the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) website by the 10th day of January, April, July, and October. Brighton is a national Third-Party Administrator (TPA). Log in or register today to get started. Apr 15, 2024 · On May 23, 2024, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) submitted the Prescription Drug Data Collection (RxDC) Report to the Centers for Medicare & Medicaid Services (CMS) for plan year 2023. Blue Cross NC Provider Internal Data; percentages indicated represent Blue Cross NC's PPO network as of July 28, 2022. Here you can find the latest news, updates, and resources to help you deliver quality care to your patients. Shop plans for Medicare, Medical, Dental, Vision & Employers. Call us to get answers to your Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plan, bill or claims questions. Home. Provider Pathways is a 24/7 educational resource that offers a foundation for doing business with Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Blue Cross NC is made up of multiple networks, including FEP, Medicare and Medicaid. About Blue e Provider Portal Blue Cross and Blue Shield of North Carolina Please contact Blue Cross NC by using the Provider Blue Line at 800-214-4844. It is designed to be user friendly and gives you flexibility when scheduling Healthy Blue training for yourself and your staff. Learn more about our non-discrimination policy and no-cost services available to you. Nov 1, 2022 · Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has partnered with Brighton Health Plan Solutions (Brighton) to administer claims and member and provider services on behalf of Blue Cross NC to select self-insured employer group customers. com or use the Sydney Health app to start a Live Chat. geo-blue. This includes Provider Blue Books, enrollment forms and more. Learn how to join or update the Blue Cross NC network, which includes commercial, Medicare, Medicaid, and other programs. Experience Health Providers. Student Blue ℠ from Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provides quality health insurance that meets the specific needs of college and university students. Here you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies, and support for delivering benefits to Healthy Blue members. Our provider network includes: Hospital systems like Atrium, Cone Health, Duke Health, Mission Health, Novant, and UNC Health Care. Providers looking to join can find out more about these networks. The percentage of medical doctors and hospitals is based upon the number of providers that applied for a Blue Cross NC provider number and then contracted with us versus the total number of providers who applied. Get insurance delivered through your local BCBS agency. Save Time With Live Chat Find the information you need about your health care benefits by chatting with an Anthem representative in real-time. This list is subject to change at least once per quarter. HIPAA affects almost the entire health care industry, including employers. Find out the requirements, documents, and steps for different provider and facility types. Please contact 888-206-4697 ( TTY : 711) for assistance. Have questions? Call or write us! Member Services: 844-594-5070 (TTY 711) Already a member? Log in to your account and send us a message. Health care providers, find a Blue Cross NC phone number for info on eligibility, benefits and claims status, plus medical policies, contract updates and more. Blue Cross and Blue Shield Association Internal Data: about. If you're a provider looking for information about eligibility, claims status or other details, log in or register with Blue e. Please complete forms related to pre-certification, behavioral health treatment, and other similar cases before rendering service. Blue Cross and Blue Shield of North Carolina offers three drug formularies (drug lists) so Medicare beneficiaries can have options for their prescription needs. © 2024, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. About Blue e Provider Portal Medical Record Submission Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national Agents have been choosing Blue Cross and Blue Shield of North Carolina (Blue Cross NC) since 1933. For help with Blue Premier registration or account management, please contact your account administrator. See important dates, forms, resources, policies and more. HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. Providers can submit claims for members with FEP plans electronically. Blue e is a portal for providers to access member eligibility, electronic claims, ID cards, patient summaries and more. Learn how to register, use features, get help and manage users for Blue e. Incomplete forms may delay processing. Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place. Explore dental network resources through Blue Cross and Blue Shield of North Carolina, including filing claims, benefit eligibility and information, and provider news. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will implement a new Sleep Management Program. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has developed clear Fast Healthcare Interoperability Resources (FHIR) to allow members to share their data with registered applications. Reason for Update. Medical Oncology Program resources Get more information on the program, worksheets, an interactive tutorial and other helpful tools on Carelon's Blue Cross NC provider page . About Blue e Provider Portal Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Explore the health insurance options offered by Blue Cross and Blue Shield insurance agencies. Blue Cross NC members can visit any licensed dentist they choose but can save money using in-network providers. NC HealthConnex and You. Members may also wish to discuss their questions and individual medical situation with their physician. Click to learn more. HQIP was inspired by the Institute for Healthcare Improvement's "Triple Aim" initiative to improve health system performance in three areas: Patient experience (including quality and satisfaction), Health outcomes and reducing Feb 10, 2021 · The Blue Cross Blue Shield Association (BCBSA) has partnered with the GRID+ Dental Network to administer BCBS FEP Dental. Join the Blue Cross NC provider network, trusted by doctors, dentists, pharmacists and hospitals across North Carolina for more than 90 years. Take care of your dental health by making the most of your Dental Blue Select℠ plan. Filing your claims should be simple. Blue Medicare HMO Enhanced, HMO Essential and Blue Medicare PPO Enhanced share the same Medicare prescription drug list. Coronavirus Testing in the Outpatient Setting AHS – G2174 (PDF): Reviewed by Avalon 4th Quarter 2023 CAB. These forms are specific to Healthy Blue + Medicare HMO D-SNP and are required when doing business with Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Blue Cross NC and Duke Health, two of the most trusted and innovative names in health care, have come together to create Experience Health, a locally owned and operated, non-profit health plan for seniors. Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. Log in to Anthem. We are committed to supporting you in providing quality care and services to Healthy Blue members. Access the forms you need to make service requests requiring prior plan approval, pre-certification, or certification when being reimbursed through the benefits of members of Blue Cross and Blue Shield of North Carolina. With the BlueCard® program, Blue Cross NC members can get health care services and benefits while traveling or living in another Blue Plan’s service area. 16, 2003, as well as Feb 21, 2024 · Medical Guidelines. May 14, 2021 · Blue Cross and Blue Shield of North Carolina (Blue Cross NC) posted a communication on October 8, 2020, announcing our new Medicare Advantage HMO Dual Special Needs Plan (D-SNP) product offering effective January 1, 2021, called Healthy Blue + Medicare. Electronic Funds Transfer (EFT) allows providers to receive electronic payments directly in their bank account. Blue Cross NC health insurance makes bill payment super easy. As an independent licensee of the Blue Cross and Blue Shield Association, we are a trusted health insurance leader 2 and our network is dedicated to our communities. Better care starts here. As a Blue Medicare PPO or HMO member, you may have access to more than 60,000 providers 1 state-wide. Our science-based resources and health guidelines help Blue Cross NC provider networks bring the most cost effective, quality health care to our members. By choosing Student Blue, you get several important benefits: Jun 21, 2024 · Effective July 1, 2024, Carelon is changing the functionality of its Provider Portal. The new program will consider the medical necessity of studies and the clinical appropriateness of a facility- or home-based test. Care Affiliate is the provider portal for managing authorizations that is accessed via Blue e. As of December 1, 2023, more North Carolinians are able to get health coverage through Medicaid. rdmey nfmggtwi pahc qrna qnusq eldea qtujk wrnhg cvtne eteans